Article

Exercise capacity, muscle function, and physical activity levels
remain reduced in recipients of lung transplantation.
Factors associated with
this deficiency in functional exercise capacity have not been studied
longitudinally.
The study aims were to analyze the longitudinal change
in 6-minute walking distance and to identify factors contributing to this change.
DESIGN: This was a longitudinal historical cohort study. METHODS: Data from
patients who received a lung transplantation between March 2003 and March 2013
were analyzed for the change in 6-minute walking distance and contributing
factors at screening, discharge, and 6 and 12 months after transplantation.
Linear mixed-model and logistic regression analyses were performed with data on
characteristics of patients, diagnosis, waiting list time, length of hospital
stay, rejection, lung function, and peripheral muscle strength. RESULTS: Data
from 108 recipients were included. Factors predicting 6-minute walking distance
were measurement moment, diagnosis, sex, quadriceps muscle and grip strength,
forced expiratory volume in 1 second (percentage of predicted), and length of
hospital stay. After transplantation, 6-minute walking distance increased
considerably. This initial increase was not continued between 6 and 12 months. At
12 months after lung transplantation, 58.3% of recipients did not reach the
cutoff point of 82% of the predicted 6-minute walking distance. Logistic
regression demonstrated that discharge values for forced expiratory volume in 1
second and quadriceps or grip strength were predictive for reaching this
criterion. LIMITATIONS: Study limitations included lack of knowledge on the
course of disease during the waiting list period, type and frequency of physical
therapy after transplantation, and number of missing data points. CONCLUSIONS:
Peripheral muscle strength predicted 6-minute walking distance; this finding
suggests that quadriceps strength training should be included in physical
training to increase functional exercise capacity. Attention should be paid to
further increasing 6-minute walking distance between 6 and 12 months after transplantation.
CI - (c) 2015 American Physical Therapy Association.

Langue : ANGLAIS